SWAZILAND: Economic Crisis Means Short Supply of ARVs

MBABANE, Jul 25 2011 (IPS) - Swaziland’s economic crisis has affected its ability to provide healthcare as the country’s buffer stock of antiretrovirals (ARVs) has fallen below the prescribed three-month supply. And people living with HIV/AIDS are extremely concerned about what will happen to their treatment if the country cannot afford to purchase ARVs.

Led by the Swaziland National Network of People Living with HIV/AIDS (SWANNEPHA), civil society organisations took to the streets on Jul. 21 to demand that government ensure that there are enough ARVs in the country. “The ministry of health is not (being) clear if people on antiretroviral treatment (ART) are assured the availability of ARVs,” said SWANNEPHA vice-president Vusi Nxumalo as he delivered a petition to the director of National Emergency Response Council on HIV/AIDS (NERCHA).

The Swazi government is faced with an economic crisis after the Southern African Customs Union cut its revenue to Swaziland by 60 percent. The money was used to finance 60 percent of the country’s budget.

Efforts to obtain international loans are proving futile for government, which is said to be losing 11.5 million dollars a month due to corruption. Hopes to get a 176 million dollar loan from the African Development Bank were quashed after government failed to comply with some of the recommendations by the International Monetary Fund.

Government failed to cut public servants’ salaries by 4.5 percent after trade unions opposed this move calling for a change of regime in the Kingdom, which is ruled by King Mswati III and where political parties cannot contest power. Cutting salaries would enable the government to save 35.2 million dollars annually and help reduce the wage bill, which accounts for 18 percent of GDP – one of the highest in the region.

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So desperate is the situation that Swaziland has even approached the South African government for a loan but there is strong opposition from the Congress of South African Trade Unions (Cosatu) and the South African Communist Party (SACP), which form a tripartite alliance with ruling African National Congress.

Cosatu and the SAPC are calling for political reforms in King Mswati III’s regime before South Africa could consider any financial assistance. So far, no funds are forthcoming.

As a result, many government services are grinding to a halt because there is no money to keep financing its various programmes, which were mainly available at no cost to the public. There are over 60,000 people living with HIV/AIDS on ART in the country, which has an HIV prevalence rate of 26 percent among 15 to 49-year-olds – the highest in the world.

The panic has been further aggravated by the fact that government is no longer able to send cancer patients to South Africa for chemotherapy and radiation services. These services are not available in Swaziland and local patients have attended South African private clinics for treatment, through the financial assistance of government’s Phalala Fund, which has since been exhausted.

As a result, cancer patients who cannot afford to pay for these services, which cost up to 3,000 dollars a day, are dying. So far eight cancer patients have died.

“If cancer patients are meant to pay for their medication, what will stop government from subjecting people on ART to the same situation?” wondered Nxumalo.

According to Lomcebo Dlamini, the national coordinator of Women and Law in Southern Africa- Swaziland, although the lack of ARVs will affect everyone, women will suffer more because they are taking care of the sick.

“Running out of drugs will be an additional burden to women, particularly those in rural settings,” said Dlamini. “Right now we’re dealing with food insecurity and extreme poverty.”

SWANNEPHA is still reeling from shock after finding out that some of its members eat cow dung mixed with water before taking their ARVs. People living with HIV/AIDS in Lugongolweni, in the drought- stricken Lubombo region, are caught up in the fiscal crisis after government suspended the provision of food rations to poor people. This has forced many poor people to go to bed without food. And those on ARVs say they cannot take the medication on an empty stomach and hence have resorted to eating cow dung before taking the ARVs.

Emmanuel Ndlangamandla, the director of Coordinating Assembly of Non-governmental Organisations, said it is a bad reflection on government that some people have reached a point where they are forced to eat cow dung.

“This crisis means death to ordinary people,” said Ndlangamandla. “It’s a pity that any humanitarian crisis impacts more on the poor.”

Dlamini said the economic crisis couldn’t be viewed in isolation but as part of the issue of poor governance in the country.

Meanwhile, NERCHA director Derrick von Wissel admitted that the buffer stock has gone below the prescribed three months. However, said Von Wissel, government has repeatedly assured the nation that the country will not run out of ARVs.

“There are orders in the pipeline and government has assured us that money to buy more drugs is available,” he said.

But he admitted that NERCHA, a non-profit organisation established by government to coordinate the country’s HIV response, is facing financial difficulties after government failed to give the organisation seven million dollars or 588 000 dollars monthly for administrative costs. Since April, NERCHA has not received a cent from government.

“We’re now using money for prevention to finance administrative costs, like the paying of salaries,” said Von Wissel. NERCHA also failed to secure funds from Round 10 of the Global Fund on HIV/AIDS, TB and Malaria.

NERCHA is not the only organisation facing financial difficulties but many non-governmental organisations (NGOs) are downsizing, while others have closed because they have failed to attract donors to the country.

Ndlangamandla attributed the drying up of donor funds to the fact that Swaziland is classified as a lower-middle income country amidst the worldwide economic meltdown.

“It’s sad to see NGOs closing down because they are helping a lot of people in the country,” said Ndlangamandla. And people living with HIV/AIDS are anxious about the availability of ARVs because with NGOs barely coping, they have no one to turn to for help if government runs out of the life-saving drugs.